I’d suggest sitting down before you read on, but that would just add to your risk… that’s right, sitting for long periods of time is a risk factor for low back pain and injury.

Photo courtesy of Saxon

New Study on Fatigued Muscles

A recent study undertaken at the State University of New York at Buffalo determined that “the degraded force generating capacity of the fatigued muscles can be a significant risk factor for low back pain^[1].  The research showed that prolonged sitting causes creep (changing length) in muscles primarily responsible for posture and maintaining stability in the spine.  When the same muscles were recruited for lifting or carrying following sitting, they generated less force.  In other words, muscles that have stretched from prolonged sitting are weaker, less able to stabilize and move the spine, and more prone to injury.

Examples of how this phenomenon affects us include:

• taking packages out of the trunk of the car after a long drive,
• getting the newspaper off the ground after sleeping side lying,
• transporting luggage following an airline flight,
• or bending to lift anything at work after awhile at the desk.

The key in all of these situations is that the back muscles are experiencing an increased demanded for force at a time when the muscle is least capable.  This is when injury can easily occur in these back muscles.

Simple Recommendations to Avoid Back Pain

For similar reasons, I frequently recommend that patients avoid twisting the torso while bending and lifting.  These actions put considerable strain on spinal muscles, because tissues are being asked to stabilize and move the spine simultaneously, increasing the risk of overloading the muscles.  Sitting for a long period before doing the same work only increases the risk of injury further.  So remember to take frequent breaks from prolonged sitting and give your muscles time to adjust when asking your back to do work following sitting.

The risks of warming the couch maybe even greater yet.  A newly published article described how prolonged sitting, even when adults participate in physical activity, is a factor for reduced lifespan^[2].  I will examine this topic in a later post.

1. Shin G, D’Souza C, Liu YH.  Creep and fatigue development in the low back in static flexion.  2009 Aug 1;34(17):1873-8.
2. Owen N, Healy GN, Matthews CE, Dunstan DW.  Too Much Sitting: The Population Health Science of Sedentary Behavior.  Exerc Sport Sci Rev.  2010 July;38(3):105-13.

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1. Resolve to Avoid Low Back Pain this Year

There seems to be two main groups of patients in my office. The first group always has an appointment scheduled and comes into the office for spinal adjustments on a regular basis, while the other population presents for care when they are in crisis.  These two groups illustrate two different models for healthcare.  The regularly scheduled patients are proactive and present for care to maintain their well-being.  Patients who present only when they are in pain represent care which is reactionary – this is how most Americans utilize healthcare.  Reactionary or crisis care means needing a root canal when flossing, brushing and regular cleanings would have preserved healthy teeth and gums; requiring ER services for any number of life-threatening conditions preventable with good diet and exercise; letting our automobile engines seize instead of regularly changing the oil; or visiting the doctor when back pain is too great to bear.

The Eventuality of Back Pain & Arthritis

Estimates indicate that about 80% of people will deal with significant low back pain at some point in their lives.  And a great many of us will eventually experience arthritis pain and stiffness.  Just witness the huge proliferation in products to treat joint discomfort, low back and arthritis pain as a testament to this expanding problem.  From the New England Journal of Medicine, a review found that a clear diagnosis could not be made in near 85% of low back injury cases^[1].  After careful examination, abnormalities could not be found.  Another study, with emphasis on imaging, determined that 97% of low back pain was mechanical in nature^[2].  Maybe degeneration is not pathological, but normal…

Pain, injuries and accelerated degeneration are the result of biomechanical stress.  Indeed, Wolff’s Law tells us that any bone, subjected to prolonged biomechanical stress will adapt to that stress^[3].  This is the same process that causes premature degenerative changes, osteoarthritis, and loss of joint motion.

How Do We Combat These Changes?

With treatments to resolve structural imbalances and support proper biomechanics.  Chiropractic maintenance care is effective because it allows patients to preserve good spinal biomechanics and smooth, pain-free joint mobility.

We know how to abide by a more sensible, preventative model.  We follow a similar paradigm in the maintenance of our teeth and automobiles.  Unfortunately, our spines are not something that can be replaced.  Start the new year off right and resolve to keep your spine happy and healthy for years to come.

Call Matthews Chiropractic Center today to schedule a spinal biomechanical evaluation and get on the road to wellness.

1. Deyo RA, Weinstein JN.  Low Back Pain. N Engl J Med. 2001 Feb 1;344(5):363-70.
2. Jarvik JG, Deyo RA.  Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002 Oct 1;137(7):586-97.
3. “Wolff’s Law.”  Stedman’s Medical Dictionary.  26th ed.  1995.  Print.

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1. October is National Chiropractic Month

Overuse of Antibiotics Leads to Ineffectiveness

Of course, antibiotics have there place and can be invaluable in countering bacterial infections, but increasingly, they are losing their effectiveness.  Stronger and stronger medications are needed as patients and their doctors are faced with growing numbers of antibiotic-resistant superbugs.  Reasons for this problem include, but are not limited to, the unnecessary use of antibiotics in household products, antibiotic prescriptions for non-bacterial infections, and the use of antibiotics in food animals.  Repeated overuse of antibiotics selects for more virulent, drug-resistant strains of the organisms that we are trying to eliminate.

When you shop for hand soap, bath soap, hand lotions, dishwashing detergents, surface cleaners, toothbrushes, linens, towels, children’s toys and more, try to select items that are free of antibacterial agents (and possibly even environmentally friendly).  Sometimes it can be hard to find soaps, cleaners, and household goods untainted by antibacterial agents, but if you look carefully you can find them…

Know Your Food

Now, another place where you might not expect to find antibiotics is in your meat products.  Commercially raised chickens, pigs, cattle, dairy cows, and others contain antibiotics in their feed as part of their normal diet.  Buying locally raised meat and chicken at a local farmers’ market is a good way to avoid antibiotics, as well as, growth hormone and other fillers.  Visit the Matthews Community Farmers’ Market on North Trade Street, in Downtown Matthews, NC for fresh, locally produced free-range eggs, pastured pork, grass-fed beef, produce, and more.  Come shop with your neighbors, support the local community, and save antibiotics for treating bacterial infections.

1. http://www.cdc.gov/ncidod/eid/vol7no3_supp/levy.htm
2. http://www.mayoclinic.com/health/hand-washing/HQ00407

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4 Tips for Desk Jockey Comfort

1. Maintain Good Posture / Ergonomics

Make sure that your back is supported by your chair^[3], Use a foot rest, Make your hips higher than your knees using a stress wedge or tilt the back of the seat slightly higher than the front, If you recline your backrest also tilt the seat backwards^[4].

2. Postural Breaks / Change Position

Take regular breaks from sitting, Get up to stretch and walk every 30 minutes, Change the height of your chair periodically, Do some work standing, Sit on an exercise ball at your desk.

It’s easy to get lost in your work. Some patients set timers that remind them that they should get up and take a walk. Your best work happens when you are relaxed and feel good. Don’t press on when your body tells you it’s time for a break. Do so and you will be better for it.

3. Core Strengthening / Conditioning

Muscles of the back and core fire constantly to maintain stable, upright/sitting posture. Eventually, these muscles can become tired and that makes the back sore and prone to injury. Therefore, strengthening and stretching muscles of the core and deep muscles of the back can help prevent pain and low back injury.

I would recommend starting with 4 exercises that require no equipment:

• Cat-Camel
• Curl-up
• Side Bridge
• Bird Dog

Descriptions of these exercises can be found at the American Council on Exercise website.

4. Chiropractic Care

The dangers of prolonged sitting are well documented. In fact, it has been shown that sitting changes the curvature of the spine and increases pressure in the discs^[5][6]. Chiropractic treatment in my office can help combat the muscular pain and spinal fixation that result from maintaining the spine in stressful postures.

A basic rule of thumb is if it hurts, it needs to move. Drink lots of fluids, take breaks, stretch it out, and as a part of a wellness program get chiropractic adjustments.

Do you have a tip or story you’d like to share about fixing the workplace to better suite your back? Please share them with us.

1. Kyphosed seated postures: extending concepts of postural health beyond the office. Pynt J, Mackey MG, Higgs J. J Occup Rehabil. 2008 Mar;18(1):35-45.
2. The response of the nucleus pulposus of the lumbar intervertebral discs to functionally loaded positions. Alexander LA et al. Spine. 2007 Jun 15;32(14):1508-12.
3. Effectiveness of a lumbar support continuous passive motion device in the prevention of low back pain during prolonged sitting. Aota Y et al. Spine. 2007 Nov 1;32(23):E674-7.
4. Lumbar spine curvature during office chair sitting. Lengsfeld M et al. Med Eng Phys. 2000 Nov;22(9):665-9.
   
5. Lumbar lordosis. Effects of sitting and standing. Lord MJ et al. Spine. 1997 Nov 1;22(21):2571-4.
6. Ergonomics of posture–review of various problems of standing and sitting posture. Grandjean E, Hünting W. Appl Ergon. 1977 Sep;8(3):135-40.

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1. How did I hurt my back?